Active NPI
Marcy Engebretson, PMHNP-BC
- Registered Nurse
- Tomah, WI
National Provider Identifier
1649028887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 124582-30
- Practice address
- 500 E Veterans St
Tomah, WI 54660-3105 - Phone
- (608) 372-3971
- NPI assigned
- May 13, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 15021 | WI | |
| Registered Nurse | 163W00000X | 124582-30 | WI | Primary |
Addresses
Primary practice location
500 E Veterans St
Tomah, WI 54660-3105
Mailing address
N5329 Camden CT
Black River Falls, WI 54615-1337
Phone (715) 896-1192
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 124582-30 | WI | MD | Registered Nurse |
| 15021 | WI | MD | Psychiatric/Mental Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1715558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777248000000",
"number": "1649028887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "N5329 CAMDEN CT",
"city": "BLACK RIVER FALLS",
"state": "WI",
"postal_code": "546151337",
"telephone_number": "715-896-1192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 E VETERANS ST",
"city": "TOMAH",
"state": "WI",
"postal_code": "546603105",
"telephone_number": "608-372-3971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGEBRETSON",
"first_name": "MARCY",
"credential": "PMHNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-13",
"last_updated": "2026-04-27",
"certification_date": "2026-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "WI",
"license": "15021",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "124582-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tomah, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.